A nursing information model process for interoperability

Abstract

The ability to share nursing data across organizations and electronic health records is a key component of improving care coordination and quality outcomes. Currently, substantial organizational and technical barriers limit the ability to share and compare essential patient data that inform nursing care. Nursing leaders at Kaiser Permanente and the U.S. Department of Veterans Affairs collaborated on the development of an evidence-based information model driven by nursing practice to enable data capture, re-use, and sharing between organizations and disparate electronic health records. This article describes a framework with repeatable steps and processes to enable the semantic interoperability of relevant and contextual nursing data. Hospital-acquired pressure ulcer prevention was selected as the prototype nurse-sensitive quality measure to develop and test the model. In a Health 2.0 Developer Challenge program from the Office of the National Coordinator for Health, mobile applications implemented the model to help nurses assess the risk of hospital-acquired pressure ulcers and reduce their severity. The common information model can be applied to other nurse-sensitive measures to enable data standardization supporting patient transitions between care settings, quality reporting, and research.

Big Data in the Veterans Health Administration: A Nursing Informatics Perspective

“…Initially, nursing informaticists focused on the design and validation of big data from financial systems to provide nursing leadership with demographic and financial nursing indicators from the unit level to the national level to manage nursing resources across VHA nursing. Their next steps focused on nurse‐sensitive indicators, and an evidence‐based information model was created to capture essential nursing data from hospital‐acquired pressure ulcers to share between organizations (Chow et al, 2015). Nursing informaticists within the VHA continue to evolve and build upon these foundational nursing informatics strategies to seek opportunities to provide excellence in patient care to our nation’s Veterans and their families.…”

Information Technology in Health Care: Information Retrieval, Processing, and Protection (Review)

“…Computer technologies have revolutionized medical imaging (table, graph, picture), solved problems of creating, obtaining, archiving, storing and exchanging high-quality scan images, increased the importance of electronic medical notes [68,69]. However, about 80% of the information cannot be processed automatically because it is stored in an unstructured form [70].…”

“…Centralized databases require powerful and expensive search engines as data comes from information systems in different formats and may have differences in schema and encoding making it difficult to recognize the content of a certain source. Often only abstracts of articles are processed, which makes it almost impossible to exchange and integrate data [68,[100][101][102].…”

“…The problem of centralized databases is clinical terminology differences in various medical databases [140]. It is impossible to find all the available information in a centralized database at user request, about 90% is estimated as a good result, however, the information obtained may be false or outdated, since the source of information is not recorded [68,141]. The accuracy of text interpretation even in standardized medical records in databases is insignificant: it is 0.897 for subject "test", 0.852 -"face", 0.855 -"problem", 0.884 -"treatment" [25].…”

Modeling Flowsheet Data to Support Secondary Use

“…1,2 Other investigators have operationalized flowsheet data in ontologies for inclusion in data repositories, 3,4 but investigators have reported data harmonization problems and, consequently, limitations for multi-site studies. In one study, a data-driven ontological approach was used to create a pressure ulcer information model.…”